For our Week 4 meeting, we had Dr. Julie Greenberg come and speak about Integrative Dermatology. Dr. Greenberg is a licensed Naturopathic Doctor and a Registered Herbalist who specializes in Integrative Dermatology. Along with being a founder of The Center for Integrative & Naturopathic Dermatology Inc., she also has published research on the gut microbiome of acne patients. In our workshop, Dr. Greenberg went over the basics of the gut microbiome connection and her research in regards to the causes of acne.
For some background, the gut microbiome coexists with the human body; we provide it with nutrients that it uses to create substances (such as vitamin B12 and butyrate) for us. A healthy gut microbiome is necessary to help digestion and to help with the immune system.
Dr. Greenberg continued to explain that acne is caused by excess sebum (oil) production or by an accumulation of skin cells that congests a hair follicle. From the congested hair follicles, bacteria may form causing bacterial acne, like Cutibacterium acne (C acne). Additionally, there may be fungal acne that forms due to Malassezia (a type of fungi) entering the hair follicle. Researchers have looked at indigenous cultures that are completely non-westernized (Aché people from Paraguay, Okinawa prior to WWII, and Kitava people from Papa New Guinea) and found that there was no presence of acne in the entire population during the observed time period. These findings suggested that acne is caused by a westernized diet. Some other factors that may trigger acne are hormones, masks, medications, steroids, stress, excess substances (such as fluoride, Vitamin B12, etc.), and cosmetics. However, triggers are not always the root cause of acne or other conditions.
To determine the root cause of acne and other skin conditions, Dr. Greenberg, in addition to looking at blood work and other types of tests, mainly utilizes stool tests and Organic Acid Test (OAT) in order to conclude the cause of skin conditions. She explained that the stool test will help to list the types of microbes (both good and bad) present in the gut, from protozoa to bacteria. The OAT, on the other hand, measures metabolites in urine and is utilized by Dr. Greenberg to look, mainly, for fungal and yeast markers.
Dr. Greenberg’s research on acne found that those with elevated H. Pylori (Helicobacter pylori), Candida, or protozoa often had acne. H. Pylori is a bacteria that lives in the stomach. Candida is a type of fungus/yeast that is present in the skin or mucous membrane. Finally, protozoa are single-celled eukaryotes. Additionally, she found that those that have elevated protozoa also had elevated levels of H. Pylori. This is because H. Pylori can produce Urease which can neutralize the stomach aid which, in turn, allows protozoa levels to increase. Dr. Greenberg also provided a few case studies, in which, every patient showed elevated levels of these three microbes. She also explained that to treat the unbalanced levels of microbes in the gut, Dr. Greenberg will often prescribe antibacterial or antifungal herbs, certain probiotics, and fiber-rich diets (fiber is one of the key things that can help the growth of good bacteria) in order to rebalance the microbe levels.
Dr. Greenberg concluded by stating that once the acne is stopped from continually coming up, the skin often heals itself. Additionally, she emphasized the fact that balance is essential. Many of the bacteria, fungi, and protozoa discussed are already present in our skin and gut. It is the over-excess production (or the lack thereof) that may cause these skin conditions to arise.
If you would like to learn more about Dr. Greenberg and her practices, you can visit her website at either www.integrativedermatologycenter.com or www.rootcausedermatology.com.
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